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Environmental Asthma Triggers: A Training for Public Health Professionals (Healthy Homes, 2)

Length: 45 minutes
Description:This training was developed for public health professionals, to enable them to help people with asthma in eliminating or reducing the seven most common environmental exposures that can worsen asthma.
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This online training was developed by the Community Outreach and Engagement Core in the UNC Center for Environmental Health and Susceptibility, housed in the UNC-Chapel Hill Gillings School of Global Public Health. Funding was provided by the National Institute of Environmental Health Sciences.

Learning Objectives

Training Personnel


Neasha Graves, MPA
Community Outreach and Education Manager
UNC-Chapel Hill Institute for the Environment


Ki'Yonna Jones, MHA/MBA

NCIPH Reviewers:

Ki'Yonna Jones, MHA/MBA

Brianah Williams B.S.

Subject Matter Expert Reviewers:

Neasha Graves, MPA
Community Outreach and Education Manager
UNC-Chapel Hill Institute for the Environment

Kathleen Gray, MSPH, Ph.D.
Director, Environmental Resource Program
Associate Director for Outreach and Public Service
Clinical Assistant Professor
UNC-Chapel Hill Institute for the Environment

The author(s) and reviewer(s) of this training have no personal financial relationships with commercial interests relevant to this presentation to disclose. Author, narrator, reviewer affiliations listed were current at the time of training development.

Competencies and Capability Functions Addressed

This training addresses selected applied epidemiology, core public health, and public health preparedness and response competencies and public health preparedness capability functions. (Please note: The competencies included on this site are just a few of the public health competencies which have been established. Training participants may find alignment between this training and other competency sets not included on this site.)

  • This training does not map to any of the competencies currently included on this website.


[View References]

ATSDR. (2014). Toxics Substances Portal - Nitrogen Oxides. Retrieved 2017, from https://www.atsdr.cdc.gov/toxfaqs/tf.asp?id=396&tid=69

Alexis, N. et al. (2013, February). The Glutathione-S-Transferase null genotype and increased neutrophil response to low level ozone (0.06ppm). Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509264/.

American Academy of Allergy, Asthma and Immunology. Indoor Allergens. Retrieved 2018, from https://www.aaaai.org/conditions-and-treatments/library/at-a-glance/indoor-allergens.

American Academy of Allergy, Asthma and Immunology. Outdoor Allergens. Retrieved 2017, from https://www.aaaai.org/conditions-and-treatments/library/allergy-library/outdoor-allergens.

American Academy of Allergy, Asthma and Immunology. Pet Allergy Overview. Retrieved 2017, from https://www.aaaai.org/conditions-and-treatments/allergies/pet-allergy.

American College of Allergy, Asthma and Immunology. (2014). Asthma. Retrieved 2017, from https://www.aaaai.org/conditions-and-treatments/asthma

American College and Allergy, Asthma and Immunology. (2018, February 1). Cockroach Allergy. Retrieved 2018, from http://acaai.org/allergies/types/cockroach-allergy.

American Lung Association (2017, September). What is asthma? Retrieved 2018, from http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/learn-about-asthma/what-is-asthma.html

American Thoracic Society. (2017, September). Allergy and Asthma. Retrieved from https://www.thoracic.org/statements/allergy-asthma.php

Asthma and Allergy Foundation of American. (2015). Dust Mite Allergy. Retrieved 2017, from http://www.aafa.org/page/dust-mite-allergy.aspx

Asthma and Allergy Foundation of America. (2015, October). Pet Allergy: Are you allergic to dogs or cats? Retrieved 2017, from http://www.aafa.org/page/pet-dog-cat-allergies.aspx.

Asthma and Allergy Foundation of America. (2015, October). Pollen Allergy. Retrieved 2017, from http://www.aafa.org/page/pollen-allergy.aspx.

Belanger K., Holford, T.R., Gent, J.F., Hill, M.E., Kezik, J.M., Leaderer, B.P. (2013). Household levels of nitrogen dioxide and pediatric asthma severity. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/23337243.

Carolinas HealthCare System. Electronic asthma action plan application. Retrieved 2018, from https://asthma.carolinashealthcare.org/Form.

CDC. (2012, August). Cleaning Up after Rodents. Retrieved 2018, from https://www.cdc.gov/rodents/cleaning/index.html.

CDC. (2013). National Health Interview Survey. Retrieved from https://www.cdc.gov/nchs/nhis/nhis_2013_data_release.htm.

CDC. (2013). Percentage of People with Asthma who Smoke. Retrieved 2017, from https://www.cdc.gov/asthma/asthma_stats/people_who_smoke.htm.

CDC. (2017, September 5). Facts about Mold and Dampness. Retrieved 2017, from https://www.cdc.gov/mold/dampness_facts.htm.

CDC. (2017, May). Strategies for Addressing Asthma in Homes. Retrieved 2017, from https://www.cdc.gov/asthma/pdfs/Asthma_In_Homes_508.pdf.

CDC. (2018, May). Vital Signs: Asthma in children. Retrieved 2018, from https://www.cdc.gov/vitalsigns/childhood-asthma/index.html.

Cornell Cooperative Extension. IPM for Homes. Retrieved 2017, from http://ccetompkins.org/resources/ipm-for-homes.

Curtis, L., Wolf, M.S., Weiss, K.B., Grammer, L.C. (2012, March). The Impact of Health Literacy and Socioeconomic Status on Asthma Disparities. Retrieved 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509174/.

Desager, K., Vermeulen, F., & Bodart, E. (2017, December). Adherence to asthma treatment in childhood and adolescence - a narrative literature review. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/29228891.

Favarato, G., Anderson, H.R., Atkinson, R., Fuller, G., Mills, I., & Walton, H. (2014, December). Traffic-related pollution and asthma prevalence in children. Quantification of associations with nitrogen dioxide. Retrieved 2017, from https://link.springer.com/article/10.1007/s11869-014-0265-8.

Fuhrmann, C. M., Sugg, M. M., & Konrad, C. E. (2016, May). Airborne pollen characteristics and the influence of temperature and precipitation in Raleigh, North Carolina, USA (1999-2012). Retrieved 2017, from https://link.springer.com/content/pdf/10.1007%2Fs10453-016-9442-6.pdf.

Government Publishing Office, Environmental Protection Agency. Definitions. Retrieved 2017, from https://www.gpo.gov/fdsys/pkg/CFR-2011-title40-vol31/pdf/CFR-2011-title40-vol31-sec745-83.pdf

Guarnieri, M. & Balmes, J.R. (2014, May). Outdoor Air Pollution and Asthma. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465283/pdf/nihms697273.pdf.

Healthy Housing Solutions (2017, September). Cockroaches. Retrieved 2018, from http://healthyhousingsolutions.com/wp-content/uploads/2015/03/IPM_Cockroaches_Sept2017.pptx.

Hernandez, M.L., Herbst, M., Lay, J.C., Alexis, N.E., Brickey, W.J., Ting, J.P.Y., Zhou, H., & Peden, D.B. (2012, October). Atopic asthmatics have reduced airway inflammatory cell recruitment after inhaled endotoxin challenge compared to healthy volunteers. Retrieved 2017, from http://europepmc.org/articles/PMC3652253.

Holsey, C., Collins, P., & Zahran, H. (2013). Disparities in Asthma Care, Management, and Education Among Children With Asthma. Retrieved 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999068/pdf/nihms809049.pdf.

Jaspers, Ilona. (2017, August 30). E-Cigarettes and Potential Adverse Health Effects: What We Do and Do Not Know. Presentation to NC Lead/Healthy Homes Task Force, Chapel Hill, NC.

Kanchongkittiphon, W., Mendell, M.J., Gaffin, J.M., Wang, G., & Phipatanakul, W. (2015). Indoor Environmental Exposures and Exacerbation of Asthma: An Update to the 2000 Review by the Institute of Medicine. Environmental Health Perspectives. Retrieved 2017, from https://ehp.niehs.nih.gov/1307922/

Krieger, J., Jacobs, D.E., Ashley, P.J., Baeder, A., Chew, G.L., Dearborn, D., Hynes, H.P., Miller, J.D., Morley, R., Rabito, F., Zeldin, D.C. (2010, September-October). Housing Interventions and Control of Asthma-Related Indoor Biologic Agents: A Review of the Evidence. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/20689369.

Kunzli, N., Avol, E., Wu, J., Gauderman, W.J., Rappaport, E., Millstein, J., Bennion, J., McConnell, R., Gilliland, F.D., Berhane, K., Lurmann, F., Winer, A., & Peters, J.M. (2006, December). Health Effects of the 2003 Southern California Wildfires on Children. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/16946126.

Laumbach, R., Meng, Q., & Kipen, H. (2015, January). What can individuals do to reduce personal health risks from air pollution? Retrieved 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311076/.

Lipton, David. (2016). Update: Managing Citizen Inquiries about Dampness and Mold Growth. Retrieved 2017, from http://epi.publichealth.nc.gov/oee/mold/docs/Mold_Moisture_Presentation_short.pdf

Martin E.M., Clapp, P.W., Rebuli, M.E., Pawlak, E.A., Glista-Baker, E., Benowitz, N.L., Fry, R.C., & Jaspers, I. (2016, July). E-cigarette use results in suppression of immune and inflammatory-response genes in nasal epithelial cells similar to cigarette smoke. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/27288488.

Miller, D.M. and Meek, F. (2004, April). Cost and Efficacy Comparison of Integrated Pest Management Strategies with Monthly Spray Insecticide Applications for German Cockroach (Dictyoptera: Blattellidae) Control in Public Housing. Retrieved 2017, from https://academic.oup.com/jee/article/97/2/559/2217999.

Minnesota Department of Health. (2007, September). Reducing Environmental Triggers of Asthma (RETA) in Homes of Minnesota Children. Retrieved 2018, from http://www.health.state.mn.us/asthma/documents/retafullreport0907.pdf.

National Cancer Institute. (2017, December). Harms of cigarette smoking and health benefits of quitting. Retrieved 2018, from https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet#q1.

National Cancer Institute. (2016, December). No Safe Level of Smoking: Even low-intensity smokers are at increased risk of earlier death. Retrieved 2017, from https://www.cancer.gov/news-events/press-releases/2016/low-intensity-smoking-risk.

National Center for Health Statistics. (2017, January). Asthma. Retrieved 2017, from https://www.cdc.gov/nchs/fastats/asthma.htm

National Center for Healthy Housing. (2009, January). Housing Interventions and Health: A Review of the Evidence. Retrieved 2018, from http://www.nchh.org/Research/Archived-Research-Projects/Housing-Interventions-and-Health-Outcomes.aspx.

National Institute on Drug Abuse. (2018, January). Tobacco, Nicotine, and E-Cigarettes. Retrieved 2018 from https://www.drugabuse.gov/publications/research-reports/tobacco/nicotine-addictive.

National Pest Management Association. Extermination and Control of Cockroaches. Retrieved 2017, from https://www.pestworld.org/pest-guide/cockroaches/.

National Heart, Lung and Biology Institute. (2007, October). Guidelines for the diagnosis and management of asthma. Retrieved 2017, from https://www.nhlbi.nih.gov/files/docs/guidelines/asthsumm.pdf.

National Heart Lung and Biology Institute. (August 2014). Asthma. Retrieved 2017, from https://www.nhlbi.nih.gov/health/health-topics/topics/asthma/.

NC Department of Environmental Quality. Pollen Monitoring. Retrieved 2018, from https://deq.nc.gov/about/divisions/air-quality/air-quality-data/nata-epa-national-air-toxics-assessment-for-north-carolina/pollen-monitoring.

NC DHHS Occupational and Environmental Epidemiology. (2017, December). Mold. Retrieved 2018, from https://epi.publichealth.nc.gov/oee/a_z/mold.html.

NC DHHS Tobacco Prevention and Control Branch. (2018). NC Youth Tobacco Survey. Retrieved 2018, from http://www.tobaccopreventionandcontrol.ncdhhs.gov/data/yts/index.htm.

NC Forest Service. (2017). Wildfire Statistics. Retrieved 2017, from http://ncforestservice.gov/fire_control/wildfire_statistics.htm.

NC State Center for Health Statistics. (2017, August). Annual Survey Results: Behavioral Risk Factor Surveillance System. Retrieved 2017, from http://www.schs.state.nc.us/data/brfss/survey.htm.

NC State Center for Health Statistics. (2017, January). Annual Survey Results: Child Health Assessment and Monitoring Program. Retrieved 2017, from https://schs.dph.ncdhhs.gov/data/champ/survey.htm.

NC State Center for State Health Statistics. (2017, June). 2014 Survey Results: Pregnancy Risk Assessment Monitoring System. Retrieved 2017, from http://www.schs.state.nc.us/data/prams/2014/#27.

NC State University, Extension Publications. (2015, June). Mites that "Bug" People. Retrieved from https://content.ces.ncsu.edu/mites-that-bug-people. Nunes C,, Pereira, A.M., & Morais-Almeida, M. (2017, January). Asthma costs and social impact. Retrieved 2017, from https://asthmarp.biomedcentral.com/track/pdf/10.1186/s40733-016-0029-3.

Paulin, L.M., G. B. Diette, G.B., Scott, M., McCormack, M.C., Matsui, E.C., Curtin-Brosnan, J., Williams, D.L., Kidd-Taylor, A., Shea, M., Breysse, P.N. & Hansel, H.H. (2014, August). Home interventions are effective at decreasing indoor nitrogen dioxide concentrations. Retrieved 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909253/.

Peden, D. (2015). Air Pollution and Asthma (Chapter 4 in Air Pollution and Health Effects). Retrieved 2017, from https://link.springer.com/chapter/10.1007/978-1-4471-6669-6_4.

Perrott, R.C. and Miller, D.M. (2010, March). American Cockroach. Retrieved 2017, from http://pubs.ext.vt.edu/444/444-288/444-288.html.

Portnoy, J., Miller, J., Williams, P.B., ... Wallace, D. (2013, December). Environmental Assessment and Exposure Control of Dust Mites: a Practice Parameter. Retrieved 2017, from https://www.sciencedirect.com/science/article/pii/S1081120613007187?via%3Dihub.

Potaczek, D.P., Harb, H., Michel, S., Alhamwe, B.A., Renz, H., & Tost, J. (2017, April). Epigenetics and Allergy: From Basic Mechanisms to Clinical Applications. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/28322581.

QuitlineNC. http://www.quitlinenc.com/. Retrieved 2017.

Rappold, A.G., Reyes, J., Pouliot, G., Cascio, W.E., & Diaz-Sanchez, D. (2017, May). Community Vulnerability to Health Impacts of Wildland Fire Smoke Exposure. Retrieved 2017, from https://pubs.acs.org/doi/pdf/10.1021/acs.est.6b06200.

Reponen T., Lockey J., Bernstein D.I., ... & LeMasters, G. (2012, September). Infant Origins of Childhood Asthma Associated with Specific Molds. Retrieved 2017, from https://www.sciencedirect.com/science/article/pii/S009167491200869X.

Schal, Coby. (2017, November). Pest Management. Presentation at NC Lead and Healthy Homes Task Force, Chapel Hill, NC.

Sheffield, P.E., Zhou, J., Shmool, J.L.C., & Clougherty, J.E. Ambient ozone exposure and children's acute asthma in New York City: a case-crossover analysis. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4373115/.

Shipman, M. (2012, April). Know Your Enemy: Cockroaches. Retrieved 2017, from https://news.ncsu.edu/2012/04/wms-cockroaches/.

Turner, M., Jerrett, M., Pope, C.A., ... & Burnett, R.T. (2016, May). Long-Term Ozone Exposure and Mortality in a Large Prospective Study. Retrieved 2017, from https://www.atsjournals.org/doi/pdf/10.1164/rccm.201508-1633OC

U.S. Department of Health and Human Services. (2016). E-Cigarette Use among Youth and Young Adults: A Report of the Surgeon General. Retrieved 2017, from https://e-cigarettes.surgeongeneral.gov/documents/2016_sgr_full_report_non-508.pdf.

U.S. Department of Health and Human Services. Know the Risks: E-cigarettes and Young People. Retrieved 2017, from https://e-cigarettes.surgeongeneral.gov/getthefacts.html.

US Energy Information Administration. (2017, February). 2015 Residential Energy Consumption Survey. Retrieved 2017, from https://www.eia.gov/consumption/residential/data/2015/hc/php/hc3.1.php.

U.S. EPA. (2016, October). AirNow - Air Quality Monitor Maps. Retrieved 2018, from https://www.airnow.gov/index.cfm?action=airnow.pointmaps.

U.S. EPA. Ozone Pollution. Retrieved 2017, from https://www.epa.gov/ozone-pollution.

U.S. EPA. Mold. Retrieved 2017, from https://www.epa.gov/mold.

U.S. EPA (2014, October). Basics of IPM in Schools. Retrieved 2017, from https://www.epa.gov/sites/production/files/2015-05/documents/basics-webinar-presentation-2014-10.pdf.

U.S. EPA. Indoor Air Quality. Retrieved 2017, from https://www.epa.gov/indoor-air-quality-iaq.

Vesper S., McKinstry, C., Ashley, P., Haugland, R., Yeatts, K., Bradham, K., & Svendsen, E. (2007, August). Quantitative PCR analysis of molds in the dust from homes of asthmatic children in North Carolina. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/17671663.

Winickoff, J. Friebely, J., Tanski, S.E., Sherrod, C., Matt, G.E., Hovell, M.F., & McMillen, R.C. (2009, January). Beliefs about the health effects of 'thirdhand' smoke and home smoking bans. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pubmed/19117850.

Zein, J. and Erzurum, S. (2015, June). Asthma is Different in Women. Retrieved 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4572514/.